Dana: Hello everyone and welcome to the first edition of DG’s podcast. Today’s topic is on utilizing image exchange technology to improve time-to-care delivery in the emergency setting. We are fortunate to have Dr. Kazanov with us as our guest speaker. Dr. Kazanov is the Network Administrator over at Advanced Urgent Care, which is an emergency center in Frederick, Maryland. He’ll be able to shed some light on his experience in the clinical setting.

Dr. Kazanov, thank you for joining us today. I think it would be beneficial for the audience if you could first talk a little bit about Advanced Urgent Care, your role there, and the types of patient cases your physicians see on a daily basis.

Dr. Kazanov: Dana, good morning, and I’m very glad to be with you this morning. Dana, Advanced Urgent Care was started about 10 years ago with my partner Dr. Wagner. We are both board certified emergency physicians and at the time that we decided to start this up we thought to ourselves “how can emergency physicians practice in a setting that is outside of the hospital and yet maintain their core traditional values of emergency medicine practice?” Advanced Urgent Care, which is an urgent care center by definition, was set up more towards the higher acute care than your typical urgent care. In doing so we made sure we made available to ourselves some higher end imaging equipment and diagnostic capability so that we could provide close to hospital level diagnostics.

Dana: Now of course timing is always a critical factor especially when you’re dealing with trauma or emergency cases. And for that reason I understand that your organization has made a big push towards digitizing everything to improve accessibility as well as the availability of critical patient information. As you mentioned, your center features state of the art diagnostic equipment including digital X-rays, CT scans and lab services. And you’ve also implemented an electronic health record, correct?

Dr. Kazanov: Correct, Dana all of this is to provide a constant stream of communication to outside providers that would require additional timely diagnostic information. And I think that is the core of the subject here.

Dana: You’ve recently rolled out an image exchange component. Can you talk a little about the capabilities that this image exchange provides?

Dr. Kazanov: Yes, basically in conjunction with Frederick Memorial Hospital and the kindly help that we were provided. In terms of a background, we see plenty of patients who walk into our center with abdominal pain and occasionally traumatic injuries. There have been plenty of times where we have diagnosed acute spleen injuries /ruptured spleens, we see plenty of cases of appendicitis and advanced cases of diverticulitis. In terms of diagnostic modalities the CT scan is really the modality of choice in diagnosing these patients. And proceeding forward when we had to refer the patient to the emergency department because we deemed them unstable to be treated as an outpatient, typically the patient had to go over with a CD of the image. Or in the past, we actually had to print these images on special translucent radiographic paper.

It was decided with tremendous help from Frederick Memorial and with helping our patient care that we could send the images directly to the hospital to their DICOM Grid. So that ultimately the treating physicians could see these images and provide timely care.

Dana: So definitely having the ability to access and share images with other facilities, whether that be one of the radiology groups that you work with or Frederick Memorial Hospital is super important. I’m wondering, has there been a patient story of patient experience that happened recently that might paint the picture for us.

Dr. Kazanov: Absolutely, just recently we had a patient that was sent over to us by one of the local gastroenterologist. Basically this patient needed to be evaluated by us to see what was going on. Ultimately the patient was diagnosed with a fairly high-grade diverticulitis. The ability to share with the gastroenterologist rapidly those images so he could physically see what was going on was really helpful. It really benefited patient care because of the timeliness in which the information was conveyed.

Dana: It’s interesting that you bring up that story, because I have a family member who has that same condition and I remember the symptoms came on so quickly. In the morning he was fine, and by the end of the day it was unbearable. So definitely having that access to the images right there is really important.

Let’s talk about transitioning over to a cloud-based solution. Just to give some background, it’s pretty common for organizations to use CDs or virtual private networks. And in the case of CDs, often times patients hand carry their imaging data with them to an appointment or an outside institution has to mail the CD. Now that you’re in the cloud how has that experience been overall?

Dr. Kazanov: It’s a tremendous help. We’re set up with DICOM Grid and Frederick Memorial and specifically their emergency center department. We hope to get more physicians on board with this – in particular the orthopedic practices. We see plenty of fractures and to have timely communication with the orthopedists for the review of the radiograph of the fracture is key. A lot of the times the orthopedist will not be surprised by what’s coming in their door if they have timely access to the radiographs; and especially even before they see the patient. It’s a tremendous patient care benefit.

Dana: Yes, receiving the patient image exam before the patient even arrives.

Dr. Kazanov: Absolutely. It cannot be understated. The patient may forget the CD, they may lose it. The ability to directly communicate with the ultimate treating provider with the diagnostic information that we have is absolutely critical. It’s what we believe is the best patient care possible.

Dana: Right. And actually, I think that brings me to my last question. Which is all about the usability. So when you’re rolling out this product to new groups. I just have a question about how that experience has been. Critical to the success of any technology is how easy it is to use. How has the process of bringing in this type of solution been for you? Has your medical staff found it simple to pick up, easy to use?

Dr. Kazanov: Dana for us, it’s been absolutely flawless. We’ve had no issues. We use GE Radworks PACS station reading, essentially a fancy DICOM viewer. And essentially all that required was setting up a couple of DICOM connections to a remote server. In terms of our patient flow, if I have a radiograph that needs to be uploaded to DICOM Grid I hit one button and it’s done.

Dana: Great, well this sounds fantastic. I want to thank you Dr. Kazanov for your insights and for taking the time to talk about your experiences with image exchange in the cloud. For all our listeners, If you’d like to learn more about this topic we have an entire website dedicated to just that, so you can go ahead and visit dicomgrid.com. Stay tuned for next time and everyone have a great day.

Catherine Slotnick is a passionate healthcare marketer with a deep interest in the latest & greatest in the Health IT space. As Ambra Health's senior marketing manager, Catherine primarily focuses on creating and sharing thought leadership content in the radiology and informatics space. Catherine graduated from the University of Virginia with a BA in Psychology & Art History. When she's not writing, she enjoys cooking and petting dogs that aren't hers.